LEVERAGING A NUTRIENT SUPPLEMENT TRIAL TO IMPROVE HANDWASHING BEHAVIOR | 20th International Congress of Nutrition , Granada, Spain, September 15–20, 2013.
K. Jannat1, L E. Unicomb1, C P. Stewart2, S. Ashraf1, M. Rahman1, P K. Ghosh1, S P. Luby1 | 1 International Center For Diarrheal Disease and Research, Bangladesh, India; 2 Program in International and Community Nutrition, University of California, Davis, CA, USA
Background and objectives: A conducive environment helps to establish new habits. Handwashing with soap is a difficult habit to develop in settings where soap and water is not conveniently available. We investigated the uptake of handwashing behavior as part of a lipid-based nutrient supplement (LNS) pilot trial.
Methods: Households (N=120) from a low income rural setting in Bangladesh, having at least one child aged 6-21 months, received LNS and handwashing promotion, which included handwashing stations, a device that provided soap and water together. Self reported LNS feeding practices and handwashing behavior were measured using surveys. We used spot checks to measure the proxy handwashing indicator- availability of soap and water at handwashing stations near kitchens. To examine the uptake of handwashing behavior, we calculated the relative difference (RD, 95%CI) from baseline to six months follow-up.
Results: Among caregivers, 78% reported feeding LNS using fingers, 5% mixed LNS with food, and 17% fed it directly from sachets. Caregiver’s reported handwashing before feeding increased from 10% to 97% (RD=87%; CI:81, 93). Availability of soap and water at the handwashing stations near kitchens increased from 1% to 83% (RD=82%; CI:75, 90). Caregivers who fed LNS with fingers were more likely to have observed soap and water at handwashing stations near kitchens (88%) than caregivers who mixed LNS with food or fed directly from sachets (68%, RD=20%; CI:0, 41).
Conclusions: Using hands to feed infants is common in Bangladesh. An intervention promoting handwashing with soap during child feeding was effective in improving handwashing, as indicated by soap and water presence near kitchens. Feeding of LNS in the presence of a handwashing station can provide cues to support the development of a handwashing habit.
